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Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report

Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this con...

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Autores principales: Matos, Adriano Medina, de Oliveira, Rodrigo Ribeiro, Lippi, Mauro Martins, Takatani, Rodrigo Ryoji, de Oliveira Filho, Wilson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Medicina Intensiva Brasileira - AMIB 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385992/
https://www.ncbi.nlm.nih.gov/pubmed/28444079
http://dx.doi.org/10.5935/0103-507X.20170015
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author Matos, Adriano Medina
de Oliveira, Rodrigo Ribeiro
Lippi, Mauro Martins
Takatani, Rodrigo Ryoji
de Oliveira Filho, Wilson
author_facet Matos, Adriano Medina
de Oliveira, Rodrigo Ribeiro
Lippi, Mauro Martins
Takatani, Rodrigo Ryoji
de Oliveira Filho, Wilson
author_sort Matos, Adriano Medina
collection PubMed
description Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.
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spelling pubmed-53859922017-04-14 Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report Matos, Adriano Medina de Oliveira, Rodrigo Ribeiro Lippi, Mauro Martins Takatani, Rodrigo Ryoji de Oliveira Filho, Wilson Rev Bras Ter Intensiva Case Reports Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions. Associação de Medicina Intensiva Brasileira - AMIB 2017 /pmc/articles/PMC5385992/ /pubmed/28444079 http://dx.doi.org/10.5935/0103-507X.20170015 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Matos, Adriano Medina
de Oliveira, Rodrigo Ribeiro
Lippi, Mauro Martins
Takatani, Rodrigo Ryoji
de Oliveira Filho, Wilson
Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title_full Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title_fullStr Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title_full_unstemmed Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title_short Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
title_sort use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385992/
https://www.ncbi.nlm.nih.gov/pubmed/28444079
http://dx.doi.org/10.5935/0103-507X.20170015
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